| NPI | 1326804873 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADITYA PULIKAL Authorized Agent 512-734-8060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2024-02-22 |
| Last Update Date | 2024-02-22 |